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Published on: October 20, 2023
Horizontal cleavage tear of discoid medial meniscus diagnosed on MRI and treated with arthroscopic partial resection
Michael H Elvey1, Sujith Konan, Charles V House
1Department of Trauma and Orthopaedic Surgery, University College London Hospital, 250 Euston Road, London NW1 2PG, UK. michael@wisb.com
Purpose:
To provided an evidence-based summarisation of the discoid medial meniscus in conjunction with a case report describing a novel management approach which includes MRI-assisted pre-operative planning and a limited meniscal resection.
Methods:
Case report and structured literature review of Medline referenced articles from 1941 to 2011.
Results:
Forty-one papers describing 61 patients and 82 discoid medial menisci were identified. Data extracted included patient demographics, diagnostic techniques, operative interventions, and associated pathological findings. These findings were compared with the index case report. A new technique involving MRI-assisted pre-operative planning and limited meniscal resection is described.
Conclusion:
The discoid medial meniscus remains a rare abnormality with significant associated morbidity. It continues to provide physicians with both diagnostic and interventional challenges. MRI-assisted pre-operative planning can provide surgeons with the opportunity to plan for limited resection so as to maximally lessen the probability of early-onset osteoarthritis which may result from loss of meniscal tissue.
Insights
Discoid medial meniscus is a rare knee abnormality causing pain and challenges. Novel MRI-assisted planning and limited resection can improve patient outcomes and reduce osteoarthritis risk.
Area of Science:
- Orthopedic Surgery
- Radiology
- Knee Anatomy
Background:
- Discoid medial meniscus is a congenital anomaly.
- It can lead to knee pain, clicking, and instability.
- Associated morbidity includes meniscal tears and osteoarthritis.
Observation:
- A literature review identified 61 patients with 82 discoid medial menisci.
- Common diagnostic techniques and surgical interventions were analyzed.
- The index case presented a novel management approach.
Findings:
- A new technique using MRI-assisted pre-operative planning and limited meniscal resection is described.
- This approach allows for precise surgical planning.
- The goal is to preserve meniscal tissue.
Implications:
- MRI-assisted planning can optimize surgical outcomes for discoid medial meniscus.
- Limited resection may reduce the risk of early-onset osteoarthritis.
- This technique addresses diagnostic and interventional challenges associated with this condition.
